Published online Aug 15, 2021. doi: 10.4239/wjd.v12.i8.1325
Peer-review started: January 28, 2021
First decision: March 30, 2021
Revised: April 12, 2021
Accepted: July 6, 2021
Article in press: July 6, 2021
Published online: August 15, 2021
Processing time: 193 Days and 5.8 Hours
The study of biomarkers in diabetes is quite advanced, especially in its relation to inflammatory diseases and vascular dysfunction. The study of these markers as they relate to immune diseases is quite advanced but never have been classified in early and late β-cell failure in diabetes mellitus (DM) patients. The challenge until now has been finding a key biomarker as a novel and targeted molecule for early diagnosis and therapeutic approach of DM.
An earlier study carried out by our group revealed that the diagnostic tools for DM are either not cost-effective, far too invasive or both. Furthermore, the diagnosis of DM is based on the golden rule of tolerance to glucose, and it becomes positive when 60% of the pancreas must have already been destroyed, meaning that the diagnosis comes too late.
We aimed to investigate the main biomarkers used in pediatric populations as early signs of pancreatic β-cell failure in patients presenting with risk factors such as being overweight, obesity, diabetes and metabolic syndrome.
We performed a systematic review of the literature based on the PRISMA and PICO approaches. PubMed, BIREME and Web of Science databases were searched for studies on DM and biomarkers of β-cell failure. Studies were selected in several steps and quality evaluation.
In this systematic review, we took into consideration 78 articles from which, after a selection process, we considered 20 articles for further analysis. We demonstrated that the β-cell-failure biomarkers are of two types: early and late β-cell damage. It is very useful in order to identify the evolution of the disease and separate the biomarkers in relation to the types of diabetes. The biomarkers of the early steps of β-cell failure are those that concern local or systemic inflammation processes and oxidative stress as well as those related to endothelial dysfunction processes. Finally, we explored the novelties of diabetes as a protein conformational disease and the novel biomarker called real human islet amyloid polypeptide amyloid oligomers (RIAO). Different types of biomarkers in type 1 and type 2 diabetes should be used in order to assess the role they play in the progress of diabetes in pediatric patients.
We carried out an integral study of the clinical data and the biomarkers of β-cell failure in DM in childhood. We found in the analyzed papers a significant difference between the control group and the patients.
The further value of this study lies in the promise that real human islet amyloid polypeptide amyloid oligomers level shows as a diagnostic tool, as a tool for better classification and as a therapeutic target.